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The association of pH values during the first 24 h with neurological status at hospital discharge and futility among patients with out-of-hospital cardiac arrest
- Source :
- Resuscitation. 159:105-114
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Post-resuscitation prognostic biomarkers for out-of-hospital cardiac arrest (OHCA) outcomes have not been fully elucidated. We examined the association of acid-base blood values (pH) with patient outcomes and calculated the pH test performance to predict prognosis.This was a post-hoc analysis of data from the continuous chest compression trial, which enrolled non-traumatic adult emergency medical system-treated OHCA in Canada and the United States. We examined cases who survived a minimum of 24 h post hospital arrival. The independent variables of interest were initial pH, final pH, and the change in pH (δpH). The primary outcome was neurological status at hospital discharge, with favorable status defined as modified Rankin Scale (mRS) ≤ 3. We reported adjusted odds ratios for favorable neurological outcome using multivariable logistic regression models. We calculated the test performance of increasing pH thresholds in 0.1 increments to predict unfavorable neurological status (defined as mRS3) at hospital discharge.We included 4189 patients. 32% survived to hospital discharge with favorable neurological status. In the adjusted analysis, higher initial pH (OR 6.82; 95% CI 3.71-12.52) and higher final pH (OR 7.99; 95% CI 3.26-19.62) were associated with higher odds of favorable neurological status. pH thresholds with highest positive predictive values were initial pH 6.8 (92.5%; 95% CI 86.2 %-98.8%) and final pH 7.0 (100%; 95% CI 95.2 %-100%).In patients with OHCA, pH values were associated with patients' subsequent neurological status at hospital discharge. Final pH may be clinically useful to predict unfavorable neurological status at hospital discharge.
- Subjects :
- Adult
Canada
Emergency Medical Services
medicine.medical_specialty
Resuscitation
030204 cardiovascular system & hematology
Emergency Nursing
Logistic regression
Out of hospital cardiac arrest
03 medical and health sciences
0302 clinical medicine
Modified Rankin Scale
Internal medicine
medicine
Hospital discharge
Humans
In patient
business.industry
Neurological status
030208 emergency & critical care medicine
Odds ratio
Hydrogen-Ion Concentration
Cardiopulmonary Resuscitation
Hospitals
Patient Discharge
United States
Treatment Outcome
Emergency Medicine
Cardiology and Cardiovascular Medicine
business
Medical Futility
Out-of-Hospital Cardiac Arrest
Subjects
Details
- ISSN :
- 03009572
- Volume :
- 159
- Database :
- OpenAIRE
- Journal :
- Resuscitation
- Accession number :
- edsair.doi.dedup.....38ebb9ee04f66081150787129c9b2d1a